Quality of Life of Adults With Congenital Heart Disease in 15 Countries Evaluating Country-Specific Characteristics
Quality of Life of Adults With Congenital Heart Disease in 15 Countries Evaluating Country-Specific Characteristics
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DOI：
10.1016/j.jacc.2016.03.477
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发表时间：
2016-05-17
影响因子：
24
通讯作者：
Moons, Philip
中科院分区：
文献类型：
--
作者：
Apers, Silke;Kovacs, Adrienne H.;Moons, Philip
背景生活质量(QOL)测量是了解疾病和治疗对患者生活影响的基础。目的本研究旨在探讨国际先天性心脏病(CHD)成人样本中的QOL，患者特征与QOL之间的关系，以及QOL的国际变异及其与国家特征的关系。采用线性类比量表(LAS)(0~100)和生活满意度(SWLS)(5~35)评定生活质量。患者特征包括性别、年龄、婚姻状况、教育水平、就业状况、冠心病复杂性和患者报告的纽约心脏协会(NYHA)功能分级。国别特征包括总体幸福感和6个文化维度。结果LAS组和SWLS组的中位生存质量分别为80和27。高龄、无工作、无结婚史和较差的NYHA功能分级与较低的生活质量相关(p<；0.001)。来自澳大利亚的患者生活质量最高(LAS：82)，来自日本的患者最低(LAS：72)。在对患者特征进行调整后，幸福感得分和文化维度与生活质量的变化没有关联，仅解释了患者特征前后0.1%的额外差异(p=0.56)。结论这项大规模的国际研究发现，成人冠心病患者的总体生活质量总体良好。生活质量的变化与患者的特征有关，但与特定国家的特征无关。因此，可以使用统一的标准来识别有较差生活质量风险的患者。可以制定设计干预措施以改善生活质量的一般原则。(C)2016年，由美国心脏病学院基金会提供。
BACKGROUND Measuring quality of life (QOL) is fundamental to understanding the impact of disease and treatment on patients' lives.OBJECTIVES This study aimed to explore QOL in an international sample of adults with congenital heart disease (CHD), the association between patient characteristics and QOL, and international variation in QOL and its relationship to country-specific characteristics.METHODS We enrolled 4,028 adults with CHD from 15 countries. QOL was assessed using a linear analog scale (LAS) (0 to 100) and the Satisfaction with Life Scale (SWLS) (5 to 35). Patient characteristics included sex, age, marital status, educational level, employment status, CHD complexity, and patient-reported New York Heart Association (NYHA) functional class. Country-specific characteristics included general happiness and 6 cultural dimensions. Linear mixed models were applied.RESULTS Median QOL was 80 on the LAS and 27 on the SWLS. Older age, lack of employment, no marriage history, and worse NYHA functional class were associated with lower QOL (p < 0.001). Patients from Australia had the highest QOL (LAS: 82) and patients from Japan the lowest (LAS: 72). Happiness scores and cultural dimensions were not associated with variation in QOL after adjustment for patient characteristics and explained only an additional 0.1% of the variance above and beyond patient characteristics (p = 0.56).CONCLUSIONS This large-scale, international study found that overall QOL in adults with CHD was generally good. Variation in QOL was related to patient characteristics but not country-specific characteristics. Hence, patients at risk for poorer QOL can be identified using uniform criteria. General principles for designing interventions to improve QOL can be developed. (C) 2016 by the American College of Cardiology Foundation.